Business Office Technology - Claims and Reimbursement

Claims and Reimbursement (BTEC 1770)

Total Credits: 3
Lecture Credits: 2.00
Lab Credits: 1.00

Description: This course introduces you to medical insurance reimbursement; medical insurance plans and payers; regulations and accreditation in medical insurance, as well as the claims processing sequence; collection of patient information; insurance verification; and encounter form preparation. You will also learn about linkage and compliance, provider payment calculations, claims preparation, and claims transmission. Coding guidelines will also be reviewed. The hospital claims and billing process will also be addressed. Computer simulations using Medisoft software will be covered during this course. Must be taken A-F.

Topical Outline:

Learning Outcomes:
1. 1. Apply health plans regulations
2. 2. Create and transmit clean claims
3. 3. Assess properly linked diagnosis and procedure codes
4. 4. Demonstrate security measures in electronic claims transmission
5. 5. Prepare hospital billing statements
6. 6. Calculate RBRVS payments under the Medicare fee schedule

Prerequisites: 

BTEC 1700.